The mission of Prognosis is to explore the nexus at which healthcare policy meets healthcare practice and how one affects the other. This blog makes readers more aware of the innovations taking place in healthcare delivery, financing and technology and the types of public policies that will encourage further progress.

Healthcare In Focus is a public education initiative of the HLC, created to promote a constructive dialogue about the state and future of American healthcare.

Yesterday, I had the honor of participating in Disruptive Women’s first 2010 breakfast series entitled Health Reform: US Patience (not a typo) Pay the Price. To read a recap of this event please visit the Disruptive Women In Health Care Blog.

One of the better analyses of the health reform process I’ve seen thus far comes from a conversation between Emmy-award winning interviewer Charlie Rose and Aetna CEO Ron Williams. The interview, which is published in Business Week magazine, serves as a reality check of sorts for those who believe that the passage of the health reform bill is going to automatically result in lower health costs for consumers. In the interview, Williams answers affirmatively when Rose asks if health premiums are going to increase.

“The answer is yes, and some of the things that will drive those premiums are significant additional taxes that the industry will have to pay in the first year…You might have plans that have richer benefits, and therefore you’re going to pay for benefits you may or may not want.”

Ron Williams is right. You can’t take some of the actions that were included in this health reform bill – steep taxes on health sectors, more government mandates on what must be included in benefit packages, a potentially week individual mandate structure that may encourage healthy Americans to pay a penalty instead of buying insurance – and expect consumer costs to decrease.

The question is, if costs increase, will policymakers correct the flaws that lead to higher costs or will there be finger-pointing directed at various sectors of the healthcare industry? Let’s hope we can continue the process of improving our health system without the demonization and blame games that marred the debate these last few months.

According to Ben Leedle, CEO of Healthways, “We know that well-being is comprised of social, emotional and physical health, and this partnership affords us an opportunity to develop a wider set of community interventions and access to an impressive range of experts and proven techniques. The combination of our collective abilities as companies to engage whole environments will accelerate the achievement of improved well-being for entire communities.”

Vitality Quest will be launching a national search for a community wanting to become the inaugural Vitality City, a city whose citizens enjoy a higher level of well-being and lower healthcare costs. Interested parties wanting to learn more may submit a Statement of Interest by visiting www.vitality-city.com (the submission deadline is May 14, 2010).

Research has shown a strong link between well-being, healthcare costs and engagement in the work environment. I truly commend this Healthways-Blue Zones effort and its goal of facilitating communities to live well.

The op-ed piece by Deborah Peel, who heads the Coalition for Patient Privacy, that appeared in The Wall Street Journal this week received an inordinate amount of attention. That’s because Matt Drudge of the popular Drudge Report website seized upon the Journal’s headline, “Your Medical Records Aren’t Secure” and listed it among several other stories critical of President Obama’s healthcare plan.

But Dr. Peel’s op-ed wasn’t criticizing the President. The targets of her op-ed included hospitals, pharmacies, employers and a litany of others who are out to plunder our personal medical records for financial gain. And, she alleges, these violations of confidentiality are even easier and more likely when health records are maintained electronically instead of on paper. She insists that the answer lies in giving patients the responsibility to decide what information they choose to share with medical professionals and what to keep secret.

Dr. Peel’s logic train goes off the tracks rather quickly. First of all, it’s simply not true that electronic records are less secure than paper ones. In her op-ed, she chooses to not acknowledge the role HIPAA privacy laws have played in keeping health information confidential. She ignores the new laws adopted earlier this year that strongly encourage encryption of electronic data and that impose new criminal and civil penalties for privacy violations. And you would never know from the op-ed in the Journal that hospitals, insurers and physicians throughout the country have taken extraordinary steps to safeguard patient data.

So we can see that any privacy “crisis” is overblown. The greater problem lies in the proposed solutions.

Giving patients the responsibility to decide which portions of their medical records should be open to healthcare professionals is, at best, unreasonable and, at worst, potentially deadly. It is highly unlikely that a patient without a medical background can make a sound decision on what information a physician might need to provide quality treatment.

But an even greater potential harm lies in the society-wide impact of ill-advised patient consent proposals. Enabling system-wide picking and choosing of what data enters the flow of essential information will have an impact on the many beneficial actions that are dependent upon information collection and analysis, such as:

• Reporting and tracking incidences of disease for public health purposes
• Monitoring the quality and safety of medical products
• Carrying out product recalls
• Medical research into lifesaving cures and treatments.

Our health system has dual objectives in this regard. We need to protect patient confidentiality while, at the same time, preserving the vital flow of information that protects, extends and saves lives. Some, as Dr. Peel’s op-ed demonstrates, lose sight of the need to maintain that balance. The fact is, though, that you should never have to choose between privacy and excellent healthcare, and we don’t have to.

WASHINGTON – An organization comprised of chief executives from all healthcare sectors said important progress was made today in extending health coverage to uninsured Americans, but Congress still has much work to do in addressing the underlying causes affecting the quality and cost-effectiveness of the U.S. healthcare system.

John H. Hammergren, chairman of the Healthcare Leadership Council, said today, “Congress made important strides in making health insurance more affordable for millions of working Americans.” Mr. Hammergren is chairman, president and chief executive officer of the McKesson Corporation.

But, he added, “The hard work of improving America’s healthcare system is only beginning. This bill doesn’t sufficiently address key issues that affect long-term excellence and sustainability – challenges such as aligning payment systems with quality and value, expanding use of health information technology and fixing our broken medical liability system.”

“On each of these fronts, America’s non-profit and for-profit healthcare companies are making tremendous strides in demonstrating how quality and cost-efficiency can be simultaneously achieved and they will continue to lead the way, but we still need public policies that help enable this progress,” Mr. Hammergren said.

HLC president Mary R. Grealy said the organization will be extremely active in public outreach and education to help inform uninsured Americans about the new health coverage options available to them.

“We’ve learned from the lessons of the Medicare prescription drug benefit and from our previous efforts on uninsured outreach that you can’t simply throw a new program out there and expect people to immediately understand and utilize it,” she said. “We intend to work with federal departments and agencies to make sure people have the information they need to take advantage of their new health insurance options.”

Ms. Grealy also said she believes the health reform legislative process is far from complete.

“We need to monitor the impact of this legislation to make sure that, as insurance reforms take effect, provisions requiring people to accept their responsibility to have health insurance are sufficiently strong. And we need to make certain this measure has a positive, and not an undermining, impact on the healthcare innovation that has been the hallmark of the U.S. system,” she said.

Mr. Hammergren said that HLC will continue to work closely with lawmakers to achieve further health system improvements.

“This health reform process has been a difficult, contentious one, but we shouldn’t lose sight of the fact that both Democrats and Republicans brought innovative ideas to the table. These ideas deserve further exploration as part of a reform process that is just beginning,” he said.